Whose goal is it anyway? Child-Centred Goal Setting in Therapy
Getting clear on whose motivation we are working with
Collaborative goal setting with children is an important part of executive function therapy
Goals are often held up as the backbone of therapy. They give direction, help us track progress, and offer a sense of momentum when things feel stuck. Child-centred goal setting is a key part of effective therapy outcomes, with executive function therapy often relying on meaningful, personalised goals. This is particularly relevant for parents and professionals supporting neurodivergent children.
However, research in paediatric therapy tells us that children are not always meaningfully involved in setting their own rehabilitation goals. That gap matters. When a goal is not felt or owned by the person it is meant to support, its power to motivate them in trying new things and creating change is limited.
There are some understandable reasons this happens. Goal setting itself draws heavily on executive functions, including planning, reflection, and flexible thinking. These are exactly the skills that may be developing more slowly in children with ADHD, autism, or brain injury. Alongside this, parents and professionals often arrive with clear and valid priorities. We want the child to get ready on time, complete homework, keep track of belongings, and reduce daily stress at home. These are important concerns, but they are not always motivating from a child’s perspective.
This raises a central paradox for therapy: if we are not making the child central to our goal setting, whose goals are we actually working toward?
Why having goals from a child’s perspective matters
Research on goal setting in therapy highlights goals are most effective when they are consciously chosen, specific, and appropriately challenging. When this happens, goals help direct attention and effort toward relevant actions, increase persistence towards the goal, and strengthen motivation, particularly when the goal feels meaningful and achievable.
For children, there is an added layer. Supporting motivation in children requires a sense of ownership over goals. When they are actively involved in setting goals, they are more likely to feel heard and respected. They begin to understand the purpose of therapy rather than feeling managed by it. This sense of ownership often translates into greater engagement, motivation, and follow through.
But this only happens when the goal is genuinely set by or with the child, not when the child is just going along with what others have decided.
What gets in the way in paediatric practice
In practice, goal setting with children can feel messy. Parents bring important concerns grounded in daily realities (to be on time for school, to do things without needing constant reminders, to not lose their things, to do their homework, to do their chores…). Clinicians bring professional knowledge about what will support long term functioning (such as building independence, strengthening executive function skills, developing self-regulation, and increasing participation across everyday environments). The child brings their own preferences, interests, and tolerances, which may not align neatly with either.
On top of this, the cognitive load of goal setting can be high. Asking a child to identify a problem, imagine a different future, and commit to steps in between is not a simple task, especially when executive function differences are part of the picture.
Without careful scaffolding, the process can default to adults setting goals for the child, rather than with them.
A collaborative and neuro-affirming approach
An effective approach is to treat goal setting as a shared, therapeutic process. This begins with understanding the child as a person, not a set of challenges. Building rapport, learning about interests, and noticing what matters to them creates the foundation for meaningful goal setting.
From there, it helps to make the parent perspective explicit for the child in a developmentally appropriate way. Naming why a parent has sought support, in clear and respectful language, allows the child to respond from their own point of view. Sometimes they agree. Sometimes they do not. Both responses are useful.
The key is translation. A parent goal such as “be ready for school on time” can be reframed into something that connects with the child’s motivations. This might sound like having more time to relax in the morning, avoiding repeated reminders from their parents, or getting to school without feeling rushed. Similarly, “finish homework” can become “get it done quicker so there is more time to play” or “stop it dragging on all evening.”
These reframes are not superficial, but about finding genuine points of overlap. They shift the goal from something imposed to something the child wants to work towards. As clinicians, we can also support this process by gently offering ideas that link the child’s interests with functional outcomes.
Building the skills to set and reach goals
Importantly, goal setting itself is part of an executive function intervention. When we scaffold the process of how to set meaningful goals, we are giving children an opportunity to practise executive function skills in a real and meaningful context.
A collaborative problem-solving framework can guide this, helping the child identify what is hard, consider what is getting in the way, and generate possible strategies. Some children may need highly structured support with visual prompts and simple language. Others may be ready for more flexible problem solving. The level of scaffolding can shift over time as their skills grow.
For parents and professionals, this same framework can offer a shared language. It moves the conversation from instruction and correction to curiosity and collaboration.
A practical note on functional goals
Where possible, goals should be anchored in everyday life and be observable in some way. This makes progress easier to track and supports clarity for families, schools, and funding bodies. Functional, measurable goals can still be motivating and child-centred when they are built through a collaborative process.
Bringing it together
When we step back, the question is not whether parent or clinician goals are right. It is how we bring them into alignment with the child’s own motivations. This requires time, skill, and a willingness to sit with some uncertainty.
In my experience, when children feel that their voice genuinely shapes the direction of therapy, engagement shifts. Goals become less about compliance and more about meaningful change. That shift is where therapeutic work becomes most effective, and most sustainable.
If you are interested in learning more about collaborative, child-centred goal setting, we offer regular webinars and workshops for both parents and professionals. You can explore current options on our website: Parents Hub and our Professionals Hub
Selected references
Locke, E. A., Latham, G.P., (2022) Building a practically useful theory of goal setting and task motivation. A 35-year odyssey. American Psychologist, 57(9), 705-17.
Pritchard, L., Phelan, S., McKillop, A., & Andersen, J. (2022). Child, parent, and clinician experiences with a child-driven goal setting approach in paediatric rehabilitation. Disability and Rehabilitation, 44(7), 1042–1049.